Pharm
PCSK9 Inhibitor
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PCSK9 Inhibitor
, Praluent, Alirocumab, Repatha, Evolocumab
See Also
AntiHyperlipidemic
Hyperlipidemia Management
Inclisiran
(
Leqvio
)
Mechanism
Monoclonal antibodies (PCSK9 Inhibitor)
Indications
Severe familial
Hypercholesterolemia
(e.g.
LDL Cholesterol
>190 mg/dl)
Background
Available in U.S. as of 2015
Preparations
Praluent (Alirocumab)
Repatha (Evolocumab)
Efficacy
See disadvantages below
Lower
LDL Cholesterol
up to 60%
Repatha added to
Statin
for 2 years prevents one more CV event per 74 treated ($2,000,000 per CV event prevented)
Alkhalil (2017) JAMA 317(16):1690-1691 +PMID: 28444271 [PubMed]
Disadvantages
Very expensive agents ($14,000 per year)
Contrast with
Statin
s which cost $250 per year
Statin
alone for 5 years prevents one more fatal CV event per 39 treated ($48,000 per fatal CV event prevented)
New, with only short-term data
Unknown longterm safety
Unknown mortality reduction (contrast with proven
Statin
efficacy)
References
(2015) Presc Lett 22(9): 50-1
Robinson (2015) N Engl J Med 372(16):1489-99 +PMID:25773378 [PubMed]
Stroes (2014) J Am Coll Cardiol 63(23):2541-8 [PubMed]
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